The journal of nutrition, health & aging

, Volume 16, Issue 4, pp 370–377

Efficacy of a home-based intervention programme on the physical activity level and functional ability of older people using domestic services: A randomised study

  • Marc Bonnefoy
  • F. Boutitie
  • C. Mercier
  • F. Gueyffier
  • C. Carre
  • G. Guetemme
  • B. Ravis
  • M. Laville
  • C. Cornu
Physical Activity Level and Functional Ability of Older People Using Domestic Services

Abstract

Objective

Our main objective was to assess whether a home-based program supervised by home helpers (HH) during their normal working hours can prevent excessive sedentariness (mainly maximum walking time and distance) and preserve functional status in elderly people at risk for frailty or disability and using domestic services.

Design

A four-month, open label, randomised trial with two groups called “prevention” and “control”.

Setting

In the homes of study participants.

Participants

The participants were all over 78 years old, lived independently at home, and received the visits of HHs at least once a week.

Intervention

The intervention combined a self-administered exercise program, with 10 g amino-acid supplementation under the supervision of HHs.

Measurements

Main outcome measures included physical activity (the PASE questionnaire), functional tests, nutritional and autonomy scores, and compliance (50% or more was considered satisfactory). Non-parametric methods were used for comparisons between the two groups. A linear regression model was fitted to assess the effect of the intervention on the relative variation of outcomes, adjusted for unbalanced baseline co-variables.

Results

One hundred and two persons (prevention n=53, control n=49) with a median age of 85 years were included. Their median Activities of Daily Living and Instrumental Activities of Daily Living (LADL) scores were 6 and 7 respectively. Twenty-three (44%) were good compilers for both interventions. The maximum walking time remained stable while decreasing by 25% in the control group (p=0.0015); and fewer participants had a worsened IADL score in the prevention group (p=0.05). The baseline IADL Score was significantly associated with good compliance to the prevention program (p=0.0011). In good compliers, maximum walking distance and maximum walking time increased by 29.15% (0.0 to 66.7) and 33.3% (−20.0 to 50.0) respectively.

Conclusion

This study confirms the feasibility of a prevention program supervised by HHs, and some benefit from the intervention and identifies predictors for better compliance. It will help in the design of prevention trials for elderly people at risk for frailty.

Keywords

Frail elderly exercise aging physical activity intervention home based intervention 

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Copyright information

© Serdi and Springer Verlag France 2012

Authors and Affiliations

  • Marc Bonnefoy
    • 1
    • 2
    • 3
    • 6
  • F. Boutitie
    • 5
  • C. Mercier
    • 5
  • F. Gueyffier
    • 4
  • C. Carre
    • 4
  • G. Guetemme
    • 4
  • B. Ravis
    • 4
  • M. Laville
    • 2
    • 3
  • C. Cornu
    • 4
  1. 1.Service de Médecine Gériatrique — Groupement Hospitalier Sud — Centre Hospitalier Lyon SudHospices Civils de LyonPierre-Bénite CedexFrance
  2. 2.Unité CarMeN — Faculté de Médecine Lyon Sud OuestUniversité Claude-Bernard Lyon 1LyonFrance
  3. 3.Centre de Recherche en Nutrition Humaine de Lyon — Groupement Hospitalier Sud — Centre Hospitalier Lyon SudHospices Civils de LyonPierre-Bénite CedexFrance
  4. 4.Centre d’Investigation Clinique de LyonHôpital Louis PradelBron CedexFrance
  5. 5.Service de BiostatistiqueHospices Civils de Lyon et Laboratoire Biostatistique Santé, équipe UMR CRNS 5558LyonFrance
  6. 6.Service de Médecine GériatriqueCentre Hospitalier Lyon Sud, Groupement Hospitalier SudPierre-Bénite CedexFrance

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